动静脉内瘘对心血管功能影响的临床研究

Effects of arteriovenous fistula formation on cardiovascular function

目的观察自体动静脉内瘘对慢性肾脏病发生心血管疾病因素的影响,探讨其对慢性肾脏患者的临床价值。方法研究32例动静脉内瘘手术患者,脉搏波分析测定术前2周和术后3个月血流动力学参数,以扁平压计测量颈-股脉搏波传导速度,彩色多普勒超声测量动静脉内瘘血流量。结果内瘘术成功后,总外周阻力减少,搏出量、心率、心输出量增加。收缩压和舒张压下降,颈-股脉搏波传导速度降低,左室射血分数增加,这些改变可以维持至术后3个月。结论动静脉内瘘形成可能改善透析前患者的心血管功能,自体动静脉内瘘的采用可能有助于改善预后。

Objective To investigate the effects of AVF formation on the cardiovascular factors which might be importanl in chronic kidney disease （CKD） patients. Methods 32 pre-dialysis patients who underwent AVF formation were studied 2 weeks prior Io AV F operation and 3 months post-operatively.Haemodynamic variables were measured using pulse wave analysis,carolid femoral pulse wave velocity（CF-PWV） by applanation tonometry and AVF blood flow by Doppler uhrasound. Results AVF formation was successful in 22/32 patients.3 months post-operatively,total peripheral resistance decreased,stroke volume,heart rate,cardiac ontpnt,lef! venlrieular ejection fraction（LVEF） increased.Systolic and diastolic blood pressures（BPs） and CF-PWV reduced.All the changes were largely maintained after 3 months. Conclusion AVF formation might improve cardiovascular function of pre-dialysis patients,use of native AVF may make prognosis better.